| 摘要: |
| 目的运用物元分析法建立临床肝损伤评分公式(scoring formula of liver injury,SFLI),为临床肝硬化疾病术前评估及治疗提供参考依据。方法收集肝硬化疾病患者术前血清生化指标,包括清蛋白(ALB)、前清蛋白(PA)、总胆红素(TBIL)、肌酐(SCr)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)、碱性磷酸酶(ALP)、凝血酶原时间(PT)、凝血酶原时间国际标准化比值(PT-INR)、部分凝血活酶时间(APTT)、凝血酶时间(TT)12项检测指标,采用物元分析法获得SFLI,并与Child肝功能系统评分进行比较,得到SFLI分级。结果成功构建SFLI,肝硬化程度变化以R值表示,随着肝硬化疾病患者损害程度加重,肝功能储备的R值减小。R=1 表示肝脏组织正常;0.770≤R<1表示肝脏处于早期肝硬化状态,属于肝硬化代偿期,命名为SFLI Ⅰ级；0.712≤R<0.770表示肝脏处于肝硬化代偿期与肝硬化失代偿期的交织状态,命名为SFLI Ⅰ+级；0.629≤R<0.712表示肝脏处于肝硬化失代偿期,合并腹水,命名为SFLI Ⅱ级；0.401≤R<0.629表示肝脏处于肝硬化严重失代偿期期,合并腹水,患者出现不同程度肝性脑病、肝昏迷等并发症,命名为SFLI Ⅲ级。结论SFLI能较敏感而准确地反映肝硬化损害及肝功能储备情况,有望为临床肝硬化疾病术前评估及治疗提供参考。 |
| 关键词: 肝损伤；肝硬化 评分公式 Child-Pugh分级；物元分析 |
| DOI：10.3724/SP.J.1008.2012.001227 |
| 投稿时间：2012-04-24修订日期：2012-09-12 |
| 基金项目: |
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| Establishing a scoring formula of liver injury using matter-element analysis for pre-operation evaluation of patients with liver cirrhosis disease |
| LIU Wei1,ZHENG Jun1*,ZHENG Wei-hong2,DENG Qing2,XING Rong-chun1 |
(1. Department of General Surgery, the First Clinical Medical College, Three Gorges University, Yichang 443003, Hubei, China
2. School of Medicine, Three Gorges University, Yichang 443003, Hubei, China
*Corresponding author.) |
| Abstract: |
| Objective To establish a scoring formula of liver injury (SFLI) using matter-element analysis, so as to provide evidence for preoperative assessment and treatment of patients with liver cirrhosis diseases.MethodsThe preoperative serum biochemical indicators of liver cirrhosis patients were collected, including albumin (ALB), prealbumin (PA), total bilirubin (TBIL), serum creatine (SCr), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (γ-GT), alkaline phosphatase (ALP), prothrombin time (PT), prothrombin time-international normalized ratio (PT-INR),activated partialthromboplastin time (APTT), and thrombin time (TT). The matter-element analysis was used to establish SFLI, and the results were compared with those of Child liver function system to create SFLI scores. Results An SFLI was successfully established. The scores of cirrhosis extents were expressed as the R value, which gradually decreased with the aggravation of cirrhosis. R=1 represented the normal liver tissue; 0.770≤R<1 represented early liver cirrhosis(compensatory cirrhosis), named SFLI Ⅰ; 0.712≤R<0.770 represented a state between compensatory cirrhosis and decompensated cirrhosis, named SFLI Ⅰ+; 0.629≤R<0.712 represented decompensated cirrhosis combined with ascites, named SFLI Ⅱ; and 0.401≤R<0.629 represented serious decompensated cirrhosis combined with ascites, different degrees of hepatic encephalopathy, and hepatic coma, named SFLI Ⅲ. Conclusion SFLI is a sensitive and accurate formula to demonstrate liver damage and liver function reserve during cirrhosis. It may help the preoperative assessment and treatment of the cirrhosis diseases in clinic. |
| Key words: liver injury liver cirrhosis scoring formula Child-Pugh classification matter-element analysis |
